Health

U.S. may lose measles elimination status, public health experts fear

Public health experts expressed concern Thursday about the possibility of the U.S. losing its measles elimination status, given ongoing outbreaks nationally and internationally.

“It’s not looking good for the U.S.,” Robert Kezaala, a senior health adviser for UNICEF, said at a global immunization forum at the Rayburn House Office Building.

Dr. Kezaala noted that a country loses its elimination status if the spread of an infectious disease lasts for a year.

The U.S. is now in the sixth month of its biggest measles outbreak since 1994. Measles had been declared eliminated in the U.S. in 2000.

The Centers for Disease Control and Prevention this week reported 940 measles cases in 26 states, an increase of 60 infections over the previous week, prompting U.S. health officials to consider a measles travel ban on infected travelers.



Meanwhile, large scale outbreaks in countries like the Philippines, Madagascar and Venezuela have contributed to a drastic increase in cases globally. In the first three months of 2019, more than 110,000 measles cases have been reported worldwide, up nearly 300% over the same period last year, according to the Measles & Rubella Initiative’s website.

“Measles is just a plane ride away,” said Robb Linkins, chief of the CDC’s accelerated disease control and vaccine preventable disease surveillance branch.

“If we don’t have high vaccination coverage across the United States — and that means 95% coverage of two doses of measles vaccine — it’s possible that that imported case of the measles virus can meet someone who is not immune who can then meet someone else who is not immune and then suddenly you have an outbreak,” Dr. Linkins said.

Health officials have linked the outbreaks to infected travelers who brought measles back from other countries, such as the Philippines and Israel, that are experiencing large outbreaks.

The last import of measles to the U.S. came from the Philippines, according to Dr. Kezaala.

Peter Yeo, president of the Better World Campaign, stressed the interconnectedness of the U.S. and other countries when it comes to infectious diseases. He said that when Congress supports global immunization programs and initiatives, it also is supporting the health of Americans.

To tackle the spread of infectious diseases, Dr. Linkins said the most important thing is a commitment to vaccinations across the board, noting stagnant vaccination rates in many areas.

He added that focusing on strong surveillance programs to detect infectious diseases and new means of delivering vaccines, such as a dissolving microneedle patch that can vaccinate children in 10 minutes, can also help.

Lissy Moskowitz, a senior U.S. advocacy manager for Gavi, the Vaccine Alliance, said there also needs to be a focus on long-term sustained routine immunization programs to ensure there aren’t immunization gaps and that people cannot just focus on short-term campaigns.

As the number of measles cases continue to rise in the U.S., the CDC said it will not try to predict the when any particular outbreak will come to an end. An outbreak will not be declared over until there are no new cases for a 42-day period.




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